Anxiety

Anxiety symptoms and anxiety disorders are common neuropsychiatric disturbances experienced by individuals with Parkinson’s disease (PD) [1,2]. In addition to the expected distress and associated suffering, anxiety in PD negatively impacts health-related quality of life and physical disability [3-8]. Despite anxiety and depression occurring at similar rates in individuals with PD, anxiety disturbances have received less consideration and are often undetected and under-treated. Fortunately, recent research has called attention to the frequency and impact of PD-related anxiety disorders, the heterogeneity of the various anxiety disturbances in PD, and the need for valid rating scales and treatment trials in this population [1,3,9,10]. Accordingly, this chapter provides practical information regarding the assessment, diagnosis, and current treatments for clinically significant anxiety symptoms and anxiety disorders in PD. Prevalence The prevalence of anxiety disorders and anxiety symptoms in PD is high (Table 11.1). Population-based studies in the general population of the United States and France report overall prevalence of anxiety disorders as 18% and 22%, respectively [12,13]. By comparison, prevalence estimates in PD are relatively higher than what would be expected based on estimates in most studies from the general population and other medical illnesses [12,14,15]. Even compared to other Parkinsonian syndromes, PD patients also experience more anxiety symptoms [16].